Surgical Techniques   |    
Custom Patellofemoral Arthroplasty of the KneeSurgical Technique
Domenick J. Sisto, MD1; Vineet K. Sarin, PhD2
1 Los Angeles Orthopaedic Institute, 4955 Van Nuys Boulevard, Suite 615, Sherman Oaks, CA 91403. E-mail address: laortho1@yahoo.com
2 Kinamed, Inc., 820 Flynn Road, Camarillo, CA 93012-8701
View Disclosures and Other Information
The original scientific article in which the surgical technique was presented was published in JBJS Vol. 88-A, pp. 1475-80, July 2006
DISCLOSURE: The authors did not receive any outside funding or grants in support of their research for or preparation of this work. One or more of the authors, or a member of his or her immediate family, received, in any one year, payments or other benefits in excess of $10,000 or a commitment or agreement to provide such benefits from a commercial entity (i.e., is an employee of [receives salary from] Kinamed, Inc.). No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, division, center, clinical practice, or other charitable or nonprofit organization with which the authors, or a member of their immediate families, are affiliated or associated.
A video supplement to this article will be available from the Video Journal of Orthopaedics. A video clip will be available at the JBJS web site, www.jbjs.org. The Video Journal of Orthopaedics can be contacted at (805) 962-3410, web site: www.vjortho.com.
Investigation performed at Los Angeles Orthopaedic Institute, Sherman Oaks, California

The Journal of Bone and Joint Surgery, Incorporated
J Bone Joint Surg Am, 2007 Sep 01;89(2 suppl 2):214-225. doi: 10.2106/JBJS.G.00186
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BACKGROUND: The treatment of isolated patellofemoral arthritis is controversial. Several surgical procedures have been used to treat the severely degenerated patellofemoral joint, with varying degrees of success. The purpose of this study was to determine the clinical results of a custom patellofemoral arthroplasty for the treatment of isolated patellofemoral degenerative arthritis of the knee.

METHODS: From 1995 through 2002, twenty-five patellofemoral replacements, three of which were bilateral, were performed in twenty-two patients for the treatment of isolated patellofemoral arthritis of the knee. According to the Ahlback radiographic evaluation scale, the mean preoperative score for the severity of the arthritis was 4.65 points in the patellofemoral compartment and 0.5 point in both the medial and the lateral compartment. The patients included sixteen women (two of whom had a bilateral replacement) and six men (one of whom had a bilateral replacement) with a mean age of forty-five years at the time of the index arthroplasty. Seventeen patients (nineteen knees) had had a prior procedure on the knee. The mean preoperative Knee Society functional score was 49 points, and the mean preoperative Knee Society objective score was 52 points.

RESULTS: At a mean of seventy-three months (range, thirty-two to 119 months) postoperatively, all twenty-five implants were in place and functioning well. There were eighteen excellent and seven good results. The mean Knee Society functional score was 89 points, and the mean Knee Society objective score was 91 points. No patient had required additional surgery or had component loosening.

CONCLUSIONS: On the basis of our relatively short-term follow-up study, custom patellofemoral arthroplasty appears to be a safe and effective treatment for isolated patellofemoral arthritis of the knee. We believe that the results presented in this paper justify the additional cost associated with the custom device.

LEVEL OF EVIDENCE: Therapeutic Level IV. See Instructions to Authors for a complete description of levels of evidence.

ORIGINAL ABSTRACT CITATION:"Custom Patellofemoral Arthroplasty of the Knee" (2006;88:1475-80).

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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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